Primary Health Care sustainability in rural remote territories at the fluvial Amazon: organization, strategies, and challenges

Ciencia e Saude Coletiva

article

Fausto, Márcia Cristina Rodrigues¹  Giovanella, Ligia¹  Lima, Juliana Gagno²  Cabral, Lucas Manoel da Silva³  Seidl, Helena¹ 

[1] Fundação Oswaldo Cruz;Universidade Federal do Oeste do Pará;Universidade do Estado do Rio de Janeiro

关键词: Primary health care;    Rural health;    Amazônia;   

DOI  :  10.1590/1413-81232022274.01112021

学科分类：社会科学、人文和艺术（综合）

来源: Associacao Brasileira de Pos - Graduacao em Saude Coletiva

【 摘 要 】

The article analyzes singularities of the Primary Health Care (PHC) organization in rural remote municipalities (RRM) in the Amazon under the influence of rivers and discusses challenges for comprehensive care in the Unified Health System (SUS). This is a qualitative and quantitative study of multiple cases in seven RRM through the analysis of interviews with managers, visits to services and secondary data. The RRM of the fluvial Amazon are small, with a sparse, dispersed population living in conditions of social vulnerability. Long distances, rivers and transport irregularities interfere with access to PHC services. The Family Health Strategy is implemented in the municipal system, however areas without assistance coverage, unavailability of PHC services and adaptations to the Strategy imposed by the characteristics of the context remain. The challenges are related to the financing, provision and fixation of the workforce and barriers of geographic access compromise the PHC response capacity in SUS. PHC sustainability requires strategic measures, resources and actions from multiple sectors and public agents; national support policies with feasibility for local execution, so that PHC services are established and make sense in such unique spaces.

【 授权许可】

CC BY